NEW Devon Clinical Commissioning Group

Claire Wright reveals – CCG claims it isn’t in a position to give Health Scrutiny information on the winter crisis in Devon’s NHS

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CLAIRE WRIGHT, Devon County Councillor for Otter Valley, writes: I am really disappointed to report that despite me asking at the beginning of January for the winter pressures information to be available at the 25 January Health and Adult Care Scrutiny meeting, it is not going to be provided.

Given the avalanche of very worrying “NHS in Crisis” press stories I sent several emails to committee chair, Sara Randall Johnson, at the beginning of January asking for information such as delayed discharges, A&E waits, levels of norovirus, staff vacancies and various other pieces of information.

I am really disappointed to report that despite me asking at the beginning of January for the winter pressures information to be available at the 25 January Health and Adult Care Scrutiny meeting, it is not going to be provided.

I was told it would be published as part of the performance review. However, when the agenda papers were published last week, the performance review charts gave information until the end of November only.

I have since been told by the committee chair that a representative from the NEW Devon CCG claimed that they weren’t in a position to provide the information because it would give councillors an incomplete picture.

If this isn’t infuriating enough, winter pressures data is updated on a daily basis and circulated to NHS and social care managers. They have the information. And it’s as up to date as today.

The health scrutiny committee chair indicated during a phone call with me on Saturday that she thought this was acceptable and that this data not being provided until the March meeting was fine!

When I asked (as per the email below) for the data to be provided under ‘urgent items’ I was told the issue wasn’t urgent and there wasn’t time to get the paperwork out in any case.

The refusal to supply this information, is in my view, a deliberate obfuscation. An attempt to interfere with the democratic and legitimate process of scrutiny and the NHS should have been pressed to provide it for this meeting.

Here’s my email to chair, Sara Randall Johnson, sent last Wednesday (17 January).
……………………………………………………………………………….
Dear Sara

I am very disappointed that there will be no specific written report on winter pressures at next week’s meeting.

I think that most people, given that ongoing national crisis that the NHS is experiencing right now, would find it inconceivable that our committee did not have this important information to assess how our major hospitals are managing during winter.

I see that there is an agenda item for urgent items at the beginning of the meeting.

Can I ask that this information as I previously asked for, is included in the form of written reports from the four NHS acute trusts, as an urgent agenda item. This to include delayed discharges for the winter period and up until next week, A&E waits and numbers, staffing vacancies, levels of norovirus and all the other standard winter pressures reporting that the trusts do on a daily basis for their managers.

I look forward to hearing from you.
Best wishes
Claire

Pic: Demo at Totnes last month.

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Scandal of fundamental changes to Devon’s NHS, which open door to large-scale privatisation, pushed through without public discussion – I have put them on the agenda of next week’s Health Scrutiny Committee

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CCG logoDevon’s two Clinical Commissioning Groups (CCGs) are pushing ahead with far-reaching, highly controversial changes to the NHS in the County from 1st April – without alerting the public or even the public watchdog, the Health and Adult Care Scrutiny Committee at Devon County Council.

The changes will turn the Sustainability and Transformation Plan – which itself grew out of the misnamed ‘Success Regime’ which closed our community hospital beds – into a more permanent Devon Accountable Care System. The first phase, in the first part of the financial year 2017-18, will develop integrated delivery systems, with a single ‘strategic commissioner’ for the whole county.

However the real concern is the next phase, which will lead to the establishment of Accountable Care Organisations. These will lead to services being permanently financially constrained, limiting NHS patients’ options for non-acute conditions, and pushing better-off patients even more towards private practice.

Large chunks of our NHS will be contracted out for long periods, probably to private providers. The ‘toolkit’ for this fundamental change talks about ensuring ‘that there are alternative providers available in the event of provider failure’. In the aftermath of Carillion, do we really want most of our NHS contracted out to private firms?

Devon’s public are not being consulted about this change – unlike in Cornwall where the Council has launched a public consultation – and there is no reason to believe that they want a privatised, two-tier health system.

Devon’s CCGs have pushed the change through without publicity, and it is only because I have put it on the agenda that Health Scrutiny will have a chance to discuss in advance of April 1st. I have written a 7-page paper for the Committee outlining what we know about the ACS and posing eight questions which they should ask about it.

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CCG, RD&E speakers at Honiton community event to begin ‘co-designing and co-producing’ local health services/activities – we need a similar meeting in Seaton too

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Honiton’s Health Matters – Going Forward Together
Thursday 18th January 2018, Beehive Main Hall,   9.30 for 10am start – 1.30pm
 
Book a place here: 
 
Context:  This event is the start of a community conversation with key stakeholder organisations around the future health and wellbeing of residents in response to  the new landscape affecting Honiton and its environs as a result of NHS and Government policies advocating placed-based health provision and cross-sector collaborative working.
The aim:  To discuss what we know, where there are gaps/challenges and how, as a community we will address these to ensure collaborative approaches to co-design and co-produce local health services/activities that meet the needs of all the people in our communities.
Invitees: Management and senior level employees / volunteers / trustees across the public, private, community, voluntary and social enterprise sector.
 
Speakers:
Ø Professor Em Wilkinson-Brice – Deputy Chief Executive / Chief Nurse RD&E
Ø Dr Simon Kerr – Chair, Eastern Locality New Devon CCG
Ø Julia Cutforth – Community Services Manager,  Honiton and Ottery St Mary
Ø Ways2Wellbeing  – Social Prescribing, Speaker to be confirmed
Ø Charlotte Hanson – Chief Officer, Action East Devon
Ø Heather Penwarden – Chair, Honiton Hospital League of Friends

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CCG refuses to give details of NHS cuts, Tories block attempts to record concerns – Claire Wright’s account of yesterday’s Health Scrutiny

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Claire Wright, Independent member of Devon’s Health Scrutiny Committee, has given a full account of how the latest meeting revealed the growing crisis in Devon’s NHS, the CCG’s arrogant refusal to give detailed information demanded by councillors, and the obsessive blocking by the committee’s Conservative members of any attempt to record concerns. My proposal about community hospitals, mentioned by Claire at the end of her report, lives for another day, and I will write about it shortly.

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Honiton beds now gone too – today’s vigil showed people’s appreciation of Neil Parish

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CAN YOU COME TO COUNTY HALL ON MONDAY to support the campaign for Seaton & Honiton hospital beds?

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We will be asking the committee to use its power to refer the decision to close our hospital beds to the Secretary of State for Health. This is our best opportunity to halt the closure programme.

We will be meeting on the main steps of County Hall from 1 pm to protest against the closure decisions, together with people from Okehampton (whose beds are also threatened) and other parts of Devon. Tell your friends and bring placards!

The meeting starts at 2.15 and we want as many people as possible to be in the public gallery to support our 6 speakers in the public participation session at the beginning of the meeting. As a Councillor (but not a member of the committee), I will be speaking later when we reach the item.

Howard and Anne West are organising a bus to take people from Colyford and Seaton to the meeting. Please email annewest@lineone.net AS SOON AS POSSIBLE if you would like a seat on the bus (£9).

20170614_19363760 people packed Marshlands, Seaton, last night for the planning meeting which called this demonstration. Dr Mark Welland, Seaton GP and Chair of the Hospital League of Friends, addressed the meeting which was chaired by Jack Rowland, Mayor of Seaton.

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My case for the Health Scrutiny Committee to refer the hospital beds decision to the Secretary of State

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On Monday 19 June (2.15), Devon County Council Health Scrutiny Committee will consider the NEW Devon Clinical Commissioning Group’s responses to 14 questions asked of the CCG by the Committee. If the Committee is not satisfied, it has the legal power to refer the CCG’s decisions to the Secretary of State for Health. (http://democracy.devon.gov.uk/ieListDocuments.aspx?CId=429&MId=2581&Ver=4)
I have sent this 6-page letter to the Chair of the Committee, Cllr Sara Randall Johnson, showing why the the CCG’s replies are inadequate, their decisions still demonstrably flawed, and the Committee should use its power to refer them.
I shall be speaking at the Committee, along with other representatives of the Seaton, Honiton and Axminster communities which are worst affected by these decisions. My main points are:
  1. Plans to halve the numbers of community beds do not take into account that the numbers of older people in Devon will more than double in the next two decades.
  2. East Devon needs more beds than other areas because it has the oldest population in Devon and this will continue to grow.
  3. Community beds are crucial to older patients without transport and when they are distant many relatives will have huge difficulty visiting their loved ones.
  4. Savings from the closures will be small. Both financial logic and CCG planning suggest that the real agenda is to close a number of hospitals.
  5. The CCG’s consultation was flawed because it gave no option to keep Honiton’s beds, and the CCG ignored the stronger support for Seaton from people who responded.
  6. The CCG’s reasons for choosing Sidmouth over Seaton are based on misleading use of evidence about population and age distributions (see table below, explained in letter).
  7. The concentration of beds in Tiverton, Sidmouth and Exmouth will leave the eastern margins of East Devon entirely without. The CCG’s claim that this is ‘a more even geographic spread’ is entirely false.
  8. The CCG ignored the fact that Seaton also serves the Axminster area, and has reneged on the commitment it gave when it recently closed Axminster Hospital’s beds, that beds would continue to be available in Seaton.
  9. Communities in the Seaton, Axminster and Honiton are angry about the decision and expect the Health Scrutiny Committee to refer it to the Secretary of State.
We are holding a public meeting in Seaton on Wednesday 14th (7 pm, Marshlands Centre, Harbour Road) to plan the community presence at the Health Scrutiny Committee.
Figure-3.2-Population-in-Selected-Age-Bands-by-town-2014-768x501

 

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Hospital beds fight shifts back to County Council

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The battle to keep in-patient beds in Seaton Hospital should now return to Devon County Council’s Health Scrutiny Committee, I argue in a statement issued to the press today.

The Council has the power to refer the decision of the NEW Devon Clinical Commissioning Group (CCG) to the Secretary of State for Health. In March, the Scrutiny Committee asked the CCG to answer 14 questions before the Council exercised this power. The CCG responded, but the answers will remain confidential until the June meeting of the new committee, whose members will be nominated at the Council’s Annual Meeting on May 25th.

I have now seen the CCG’s answers but I am not allowed to reveal them publicly, which I think is deplorable. However I can state that, particularly in relation to the decision about Seaton, the CCG’s case remains flimsy and threadbare. I shall be raising this matter as soon as the new committee meets and I urge other interested parties in the Axe Valley to join me in making representations. I have had a preliminary talk with Axminster’s new County Councillor, Ian Hall, and I hope we can make a cross-party case for the whole local community on this issue. I am also talking to Honiton campaigners.

Judicial review: fundraising insufficient

I am proposing this way forward after the urgent appeal for £20,000 for the first stage of a judicial review of the decision, the preparation of a ‘letter of complaint’ – which I made last Saturday following my election on Friday – failed to raise enough money to proceed. 

I was moved by the response in which about 70 donations have been made. Sadly, however, the total raised, while over £5,000, was still not sufficient to pay the solicitors to prepare the letter, for which they would have charged £16,800. It might have been possible to raise the balance after the letter was sent, but within three weeks the action itself, requiring a fighting fund of many tens of thousands, would also have had to be launched. In the light of this response, there seemed no prospect of raising the further money in the time available.

I therefore decided not to proceed with the action. I felt it was unfair to the donors to spend their money on something which could not be followed through. I have incurred some legal costs but most of the money will be returned, and I have written to those donors whose names I had (others will be contacted in due course after I have sorted things out with the League of Friends).

Case strengthened 

The appeal has had a positive effect, however, in that new evidence came to light which strengthens the case that the CCG acted wrongly in the way they made the Seaton decision. This will be used in representations to the County Council. I also urge voters to make the Seaton and Honiton hospital beds a priority with all candidates in the General Election, so that whoever is our MP makes the new Health Secretary aware of local anger about this issue.

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CCG closing Seaton Hospital beds by stealth

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The NEW Devon Clinical Commissioning Group (CCG) promised that Seaton Hospital beds would not be closed until its new ‘care at home’ scheme is in place. Yet at the Seaton Health Forum last week it was reported that occupancy, which is normally over 90 per cent, had fallen to two-thirds. And today a local resident has reported on Facebook:
“I had to take my dad to the hospital in Exeter for a procedure. This has all gone well and they were going to move him to a different ward to recuperate perhaps for ten days. I said it would be good if he could be moved to Seaton Hospital. I was told that staff had been told not to send people to Seaton. The look of disgust on the doctors face suggested that there was more to that sentence along the lines of ‘because they want to keep it empty so that it looks like it is not being used’.”
The resident concludes, ‘Do you ever get the feeling you’ve been cheated?’ and I agree. It appears that CCG is now closing Seaton Hospital’s beds by stealth. This follows Devon County Council’s refusal to release the CCG’s response to Devon’s Health Scrutiny Committee’s 14 questions, until after the County election next week. It now appears that not only have the CCG used the elections to avoid accountability, but they have reneged on their promises about implementation. 
I demand that the CCG ensure that Seaton Hospital is used normally until the new system is fully operational, and that any implementation process is transparent and subject to public scrutiny. If elected next Thursday, my first job will be to hold the CCG to account.
 
This news only increases the urgency of Seaton Town Council’s decision about judicial review, which it is due to make on Tuesday 2nd May.

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How Seaton fares in the papers for CCG meeting

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The papers for the CCG meeting on Thursday are available online. On a quick reading of the 92 pages of the report on the consultation, it is impossible to say clearly what outcomes they point to. All the report says about how the meeting will approach the decision is: ‘The scheduled date for the Governing Body to make a decision is the 2 March 2017, although a key feature in that meeting will be assessing readiness for such a key decision. The CCG has already confirmed the papers will be published and the decision will be made in public, and communicated to stakeholders afterwards. If it is decided that further work is needed prior to decision, it will be for the Governing Body to confirm the rationale and when the decision will be made.‘

However the summaries of the consultation highlight some things which are hopeful for Seaton, and maybe for the wider aim of keeping more beds in more hospitals than the CCG envisaged:

  • The public meeting in Seaton organised by Seaton Town Council, the League of Friends and the GP surgeries was easily the largest event (estimated at 250 people – I thought 300) of the whole consultation.
  • The EX12 postcode (Seaton) produced about 400 responses, almost twice the number in any other postcode (and there were about 100 from EX24, Colyton, on top).
  • The Seaton option (A) was the most supported of the CCG’s four options.
  • However ‘other (write-in) options’, many of which included retaining more beds than CCG envisaged, were even more supported than Option A overall. Almost half of all respondents did not support any of the CCG’s options.

At the very least, we can say that the Seaton community did a good job in creating awareness and promoting responses, with keeping beds in Seaton hospital strongly favoured – and much support for keeping many more beds than the CCG options offered.

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